Youth suicide and self-inflicted injury are serious public health concerns. Suicide is the second leading cause of death among young people ages 15-19 in the U.S., according to 2013 data (1). A recent national survey found that nearly 1 in 6 high school students reported seriously considering suicide in the previous year, and 1 in 13 reported attempting it (2). In addition, approximately 157,000 youth ages 10-24 are treated for self-inflicted injuries in emergency rooms every year (2). Self-inflicted injuries are not necessarily the result of suicide attempts; in fact, self-harm without the intent to die is more prevalent than self-harm with such intent (3). In total, suicide and self-inflicted injury in the U.S. cost an estimated $45 billion annually in medical expenses and work loss; actual costs may be higher as many suicides and attempted suicides are not reported due to social stigma (4, 5).

Some groups are at a higher risk for suicide than others. Males are more likely to commit suicide, but females are more likely to report attempting suicide (1, 2). Among racial/ethnic groups nationwide, American Indian/Alaska Native youth have the highest suicide rates (1, 2). Research also shows that lesbian, gay, and bisexual youth are more likely to engage in suicidal behavior than their heterosexual peers (6). Several other factors put teens at risk for suicide, including a family history of suicide, past suicide attempts, mental illness, substance abuse, stressful life events, low levels of communication with parents, access to lethal means, exposure to suicidal behavior of others, and incarceration
(1, 2).

Find more information and research about youth suicide and self-inflicted injuries in kidsdata.org's Research & Links section.

In 2011-13, nearly a fifth (19%) of California public school students in grades 9, 11, and non-traditional classes reported seriously considering attempting suicide in the past year. Reported suicidal ideation was higher among female (vs. male) students and among students from multiracial and Native Hawaiian/Pacific Islander backgrounds.

In 2013, 481 California children/youth ages 5-24 were known to have committed suicide: 29 children ages 5-14, 150 ages 15-19, and 302 ages 20-24. The state’s youth suicide rate in 2011-13 was 7.7 per 100,000 youth ages 15-24, slightly higher than previous years, but substantially lower than the rate in 1995-97 (9.4). National comparison data are available from 1999 to 2013; during those years, California's youth suicide rate remained below the U.S. rate, which has risen above 10.0 per 100,000 youth in recent years. Statewide and nationally, many more male youth (ages 15-24) than female youth commit suicide. In 2013, males accounted for almost 80% of youth suicides in California (354 of 452).

In 2013, there were 3,322 hospitalizations for non-fatal self-inflicted injuries among children and youth ages 5-20 in California. While the statewide rate of self-inflicted injury hospitalizations has fluctuated over the last two decades, rates have declined since 2001, from 46.5 per 100,000 to 39.8 per 100,000 in 2013. Most counties with available data saw a similar decline. County rates ranged from 18.8 to 56.4 per 100,000 in 2013. Statewide, the majority of hospitalizations for self-inflicted injuries involve youth ages 16-20: 2,050 (or 62%) of all hospitalizations for self-inflicted injuries in 2013.

Policy Implications

Suicide is considered a major, preventable public health problem, and it is the second leading cause of death among teens ages 15-19 nationwide (1). Some groups are at higher risk of suicide, such as LGBT youth, American Indian/Alaska Native youth, and those in the juvenile justice and child welfare systems (2). Self-inflicted injury, e.g., cutting and self-hitting, also is a serious public health concern, affecting an estimated 13%-23% of adolescents (3). While self-injury is a risk factor for suicide, many young people engage in self-harm without intent to die, and most youth who hurt themselves do not seek treatment (3). In fact, most children who need mental health treatment, in general, do not receive it (4). Screening, early identification, and access to services are critical in preventing and reducing mental health problems (4). However, experts recommend that policy strategies go beyond preventing and treating problems, to promoting positive youth mental health (4, 5).

According to research and subject experts, policy options that could promote emotional health and prevent youth suicides and self-inflicted injuries include:

Promoting efforts in communities to ensure youth have connections to caring adults and access to safe, positive activities, such as quality after-school programs and mentoring programs (5, 7, 8)

Ensuring adequate funding and training for teachers, school staff, social workers, juvenile justice staff, and others who work directly with young people to recognize signs of suicidal behavior and self-injury, and to refer youth to appropriate services; school training also should focus on how to promote a safe and supportive environment for all students, including LGBT youth (4, 5, 6)

Supporting public education and awareness campaigns to reduce the stigma associated with mental health problems and increase knowledge of warning signs; this could include “mental health first aid” training for wide-ranging audiences, focusing on how to recognize early signs, provide non-professional support, and help youth access community resources (4, 5)

Ensuring that all youth with mental health needs have access to high-quality, culturally appropriate services; as part of this, expanding the workforce of qualified mental health professionals (4, 5)

Encouraging the media to limit publicity and glamorization of youth suicide, e.g., keeping coverage brief and not explicit or sensational, to prevent contagion among other vulnerable youth (5, 10)